Many people count calories and do sports to keep fit, but adipose deposits may still exist in the body. These can be fat deposits on abdomen, hips or shoulders. Adipose tissue is differently distributed in people. When conservative treatment doesn’t help, you should consider fast body correction methods, e.g. liposuction.
Liposuction in Germany is combined with lipofilling – when person’s own fat is moved to the soft tissues of face and hands to make them look younger. Prior to liposuction, German clinics consult every patient to define the level of surgical invasion. Depending on person’s initial state, liposuction may serve to remove fat from legs, buttocks, abdomen, neck, chest and arms.
With over 11,000 liposuction operations in total, liposuction is the most common aesthetic operation in Germany, followed by breast augmentation and upper eyelid surgery.
Fast facts about liposuction
- Local or general anesthesia.
- Duration of liposuction is 1-2,5 hours.
- Liposuction is made on outpatient basis, or a person can spend a day in a clinic.
- A person can get back to work within 2-4 days after liposuction.
- Recovery period after liposuction – 6 weeks.
Types of liposuction
German plastic surgery clinics offer space liposuction – you won’t find such procedure as standard dry liposuction. Instead, clinics use:
- tumescent liposuction;
- ultrasound liposuction;
- water-jet liposuction;
- laser liposuction.
Liposuction is performed the following way: adipose tissue is destroyed and removed through small incisions with special cannulas. Methods differ by the volume of removed fat. The extent to which this or that procedure is sparing is defined by the volume of blood loss and nervous system destruction.
If you have resolved to go through liposuction in Germany, you need to find a qualified doctor who whill figure out an optimal method of fat removal. German doctors are the ones whom you can trust your health and appearance.
To perform tumescent liposuction, a doctor will soak subcutaneous tissue with a special liquid before aspiration. Tumescent liquid tightens blood vessels and makes adipose cells swell. It also blocks transfer of nervous impulses, which eliminates the need of anesthesia. Tumescent liposuction allows removing up to 6 liters of adipose tissue.
To perform this operation, a doctor also injects tumescent liquid under skin. Then adipose tissue is destroyed with ultrasound. Fat cells are destroyed and emulsified, which makes up for better aspiration of destroyed components with a lower aspirating effort. It diminishes the risk that connective tissue colony-formings and vessels will get into cannula.
Ultrasound liposuction in Germany allows removing up to 10-15 liters of fat. The main advantage of this method is that ultrasound improves skin and prevents sagging after liposuction.
3D-liposuction implies vibration and rotation of canula 3-5 mm in diameter injected in fat lobule. During the procedure, vessels and nerves are minimally affected, and adipose cells stay undamaged. Therefore, aspirated fat can be used for lipofilling.
Cannula is injected in subcutaneous tissue, and liquid under pressure is injected inside it to wash out fall cells without damaging elastic vessels and nerves. In case of waterjet liposuction, a fewer amount of anesthesia is required which makes this procedure less harmful for patient. Removed fat cells can be used for lipofilling.
In case of waterjet liposuction, any amount of fat can be removed, and rehabilitation period is shorter.
In case of laser liposuction, a laser waveguide is injected under skin: it destroys adipose tissue with the energy of light. Since hypodermic vessels are coagulated, this kind of liposuction doesn’t cause blood loss. Laser liposuction improves skin and helps to diminish its amount.
Note that laser liposuction in Germany can be used to destroy a few grams of fat – this method is suitable for correcting minor areas of body.
Indications and Preoperative Preparation
The main indication for liposuction is the appearance of certain areas of fat accumulation in adipose tissue and changes in the patient’s body contours. The patient’s age is also a precondition ‒ not younger than 18 years old. It is worth keeping in mind that the younger the patient is and the better the condition of his or her skin, the more effective this procedure is.
To prepare for the surgery, the patient goes through the following steps:
- Examination by a plastic surgeon.
- Performing general clinical examination ‒ a complete blood count test, urine examination, ECG, fluorography.
- If the person smokes, he or she should give up this habit 2 weeks before the “X” hour.
- Adjustment of medications taken.
- Selection of compression underwear.
- Choosing anesthesia method.
Features of Classical Liposuction
Liposuction is a very extensive and traumatic surgery (especially if you plan to remove a large amount of fat), so experts recommend the use of general anesthesia. But if you need to correct only a couple of zones, it is allowed to use local anesthesia.
The essence of the operation is very simple ‒ small incisions are made in the skin through which a cannula is inserted, the outer end of which is attached to a special device. The cannula is inserted into the subcutaneous fat layer and is moved there in a fanlike manner and progressively, and, thanks to the vacuum created, the fat is brought out through it into a special bag. Some experts compare the process of liposuction with the work of a vacuum cleaner.
There are several zones that cannot be processed in this way:
- Upper back and its middle third.
- Front thighs.
Despite the fact that the method of surgical liposuction has been used for more than a dozen years, the question of the amount of extractable fat at a time remains controversial. Some plastic surgeons state that the removal of 1.5 kg of adipose tissue is the optimal amount for one operation. Others say that 5, 10 and even 16 kg of fat can be removed. In recent years, the following gradation of liposuction has been adopted in plastic surgery:
- Low volume operation ‒ no more than 2.5 liters of fat are removed.
- High volume operation ‒ up to 5 liters of tissue are removed.
- Extra-high volume operation ‒ the doctor removes more than 5 liters of adipose tissue.
But you should be aware that the final decision on the amount of fat to be removed is made jointly by the plastic surgeon and the patient.
How Much Fat Can be Removed by Using Liposuction?
Plastic surgeons give an unambiguous answer to this logical question: the less, the better! Despite the wide possibilities of body contour correction, it will not be possible to drastically lose weight by using this procedure. Theoretically, more than 10 litres of fat can be removed in a completely healthy patient, but in practice some experts recommend coming to nothing more than half the volume, others consider only 3 and even 1 litre to be a safe amount.
The Optimal Amount of Surgery
On average, you can safely suction out 2-3 litres of aspirate at a time. By using the most modern techniques, this maximum can be increased up to 5 litres ‒ and this includes not only fat, but also other biological fluids and tissues, as well as Klein’s solution (a mixture of saline, local anaesthetic and vasoconstrictor component ‒ it is fed into the problem area of the body under pressure where it destroys the intercellular connections and facilitates the further removal of adipocytes and connective tissue fragments).
The decisive factor is the patient’s body weight: 5 litres will be acceptable for a person of 80-90 kg or more, but for those whose weight is considerably lower, the safe volume will be less ‒ about 2-4 litres. The surgeon also proceeds from the required amount of lidocaine which is present in the composition of Klein’s solution and, in addition, can be administered separately for additional anaesthesia ‒ in no case should an overdose be allowed. Other important factors are the condition of the kidneys and the liver (they will bear a certain burden during the recovery period), as well as the total area of the treated areas.
Why is removing a large amount of lipoaspirate a problem?
Surgical liposuction is associated with inevitable tissue injury, which, in turn, is accompanied by:
- Loss of blood ‒ the more fat is suctioned out, the more severe it will be;
- destruction of cells and extracellular structures with the formation of decay products, the elimination of which creates a considerable burden on the liver and kidneys;
- stressful change in the nature of blood circulation and cardiac activity.
For several weeks after the operation, all systems and organs of the human body work in enhanced mode, which increases the risk of developing various complications and side effects. The result is the following: the greater the scope of the surgical intervention is, the more areas are affected; the more intensively each of them is treated, the longer and harder the recovery period is. The likelihood of various undesirable consequences is also higher.
In addition, ironically enough, a large amount of fat removed often leads to a poor aesthetic result of the operation ‒ the skin cannot contract to the desired level (especially in age patients). It sags, and there are clearly noticeable irregularities and characteristic bumps under it.
What should those who have a considerable excess of adipose tissue do?
First of all, it is important to understand that liposuction is a way to correct the contours of the body, and not to reduce its mass. The point is not to suction absolutely everything ‒ surgical procedures are aimed at the point destruction of the so-called “traps”, areas in which fat is retained even after a considerable overall weight loss.
- In many patients, even in those whose body mass index is close to normal, there are several problem areas that require correction. And the total amount of excess fat can exceed the required 3-5 litres. The ideal option in this case is to perform 2-3 procedures with an interval of 2-6 months, so as to remove the surpluses little by little, within safe limits. Such a phased transformation will not create an extreme load on the body, but will make it possible for the skin to naturally contract to the new volume and restore elasticity. In addition, practice shows that the results of the first session are often sufficient and the patient is completely satisfied with the effect.
- In rare cases, the surgeon may consider it to be reasonable to remove 6 or more litres of fat at a time. Such operations are possible, but they require more thorough preparation, perfect health, and are associated with a long rehabilitation period ‒ the previous version, broken down into stages will be safer in any circumstances.
- Those who have an extremely high body mass and apply for liposuction are usually denied the surgery: removing a limited amount of fat will not make much difference in such cases, and more extensive operations are already unsafe for health. The first step in this case is to lose weight ‒ on your own or with the help of a nutritionist or a bariatric surgeon, and only after achieving a sustainable result can you start bringing the contours of the figure to perfection by using plastic surgery.
Classical liposuction undoubtedly remains one of the most popular methods of body correction, but there are other methods of lipomodelling, for example, tumescent liposuction. This type of surgery favorably differs from classical liposuction in that the surgeon makes very small incisions in the skin and uses ultrathin cannulas.
Adipocytes are destroyed by the injected solution of sodium chloride, lidocaine and adrenaline. Thanks to lidocaine, local anesthesia is possible. This surgical technique is practically no different from conventional liposuction, only the volume of adipose tissue removed should not exceed 2.5 liters.
The main benefits of tumescent liposuction are as follows:
- The use of local anesthesia eliminates the risk of the development of complications characteristic for general anesthesia: mental confusion, nausea, breathing difficulty.
- The duration of the postoperative period is reduced to 3-4 days, as this operation is less traumatic.
- Blood loss is significantly reduced.
- There is no need to use intravenous infusion.
- The use of ultrathin cannulas reduces the risk of postoperative complications such as hematomas and bruises.
- Small incisions in the skin ensure quick wound healing and the formation of inconspicuous scars.
Oscillatory Liposuction or Vibration Modeling
In an effort to make the liposuction procedure as safe and low traumatic as possible, Belgian plastic surgeons have invented a special technique ‒ vibro liposuction. This method is also called 3D lipo.
To perform the surgery, a special vibration unit is used, which supplies compressed air through thin cannulas (3-5 mm) into the adipose tissue, destroying adipocytes. The doctor evacuates the formed emulsion using a vacuum unit.
This method of lipomodeling makes it possible to remove fat deposits from very delicate areas ‒ the face, the chin and the chest. The volume of the single-stage removal of adipose tissue is relatively small ‒ 1.5 liters, but such a careful operation is a guarantee of a short recovery period (3-4 days) and the lowest risk of postoperative complications.
This is a method of removing body fat by the use of laser technology. It is minimally invasive and does not bring as much pain as the classical one. Laser lipolysis is performed as follows. A fiber-optic probe is inserted under the skin, and it is the probe that is the source of a low-intensity laser with a selective effect on fat zones. The laser simply breaks down fat cells, and through the bloodstream they get into the liver for neutralization and further removal from the body under general conditions. The duration of the procedure depends on the amount of adipose tissue, but usually it is 1-2 hours.
For large amounts of body fat, you can additionally use the method of pumping it out. It will speed up the manifestation of a positive effect and help the liver. To put it in simpler words, if you want to perform liposuction only on the pronounced lower abdomen, without affecting, for example, the body sides or the upper region, the laser will be the best way to do it.
If a classical operation makes you undergo a long period of rehabilitation and experience painful sensations, with laser liposuction everything is different. It has a short recovery period, and you can see the first pleasant results very soon.
Laser lipolysis can be called a unique and tissue-sparing procedure. It is based on the selective destruction of fat cells. This means that even very close to the area of operation tissue will not be damaged, if there is no need to correct it. As a result, it is possible to talk about the reduction of the rehabilitation period.
An additional effect is the coagulation of the associated capillaries: it means that bleeding is stopped by “blocking” the lumen of the vessels. The laser also stimulates the production of collagen which significantly tightens the skin in the area of the operation. Therefore, instead of a sagging “pregnant” paunch with flabby skin, you can see beautiful abdominal muscles without the flabbiness of the upper dermis tissues.
In what areas can liposuction be performed?
The human body stores fat according to its own laws. It depends on gender, age, nationality, diet and exercise. For women, pregnancy and childbirth are also a serious stress for the figure, after which it is not always possible to return to the previous shape. And after a caesarean section operation, instead of beautiful abdominal muscles there is a fold, hanging over the scar, the so-called “pocket”.
It is with such problem zones that the laser beam deals with. This method has one feature ‒ laser lipolysis is used only to remove fat cells in certain areas and up to 500 ml of total adipose tissue. Therefore, quite often laser liposuction is the second stage after the classical one which helps get rid of large volumes of fat tissue. Using the minimally invasive method, one can remove the remaining fat in the following areas of the body:
- on different sides of the thighs, including the inner one ‒ because of its corpulence and flabbiness it is very difficult to cope with the problem with the help of diet and exercise;
- on the abdomen and waist ‒ it is a difficult area for a modern person, taking into consideration that so many people lack motion;
- on the knees, where it will also be possible to eliminate the hypodermic irregularities and improve the appearance of the skin, rejuvenate it;
- on the buttocks, giving them back their correct shape and reducing the signs of cellulite;
- on the inner surfaces of the arms, improving the contours of the shoulders;
- on the cheeks, chin and neck. This zone is especially problematic for many people who have lost weight ‒ the body has become slim, but for some reason the double chin and swollen cheeks are preserved.
Also, by using laser lipolysis, you can solve a few delicate problems that can create a lot of trouble for both men and women. One of them is hyperhidrosis, excessive sweating, which leads not only to problems in social life, but also to health ones ‒ fungi grow in a moist environment, maceration declares itself.
The second problem which concerns only men is pseudogynecomastia, non-hormonal augmentation and sagging of mammary glands. It is caused by an excessive amount of adipose tissue in the body, but laser liposuction will save from this problem very quickly. It will also cope with small lipomas.
Contraindications for Laser Liposuction
Lipolysis is an operation, even though a minimally invasive one, so there are a number of contraindications for it. They are as follows:
- pregnancy and lactation;
- blood diseases, disorders of coagulation, hemophilia;
- liver diseases and chronic problems with it.
It is quite clear that the very period of gestation, birth and care for a baby is a serious stress for the female body, which is exactly the time when fat is needed! It provides not only the protection of the body, but also its stable hormonal background. Any contouring plastis surgery or liposuction will be useless at this time ‒ the body and face can rapidly change their shape, and the result may be unpredictable.
Blood diseases do not imply the possibility of lipolysis, since even the coagulation properties of the laser beam may not be enough to stop bleeding or control the blood flow. Such manipulations can become life threatening. In case of liver diseases, contraindications for laser liposuction are explained by the possible inability of the organ to “digest” and neutralize the split fat.
Body Tite Radiofrequency Liposuction
If there are contraindications for the classical lipomodeling, you may be offered another way to correct the figure ‒ radiofrequency liposuction. This technique is based on the effect high frequency current has on fat cells. Body tight liposuction is performed with two electrodes:
- Internal ‒ it is placed into the subcutaneous adipose tissue and is used to destroy adipocytes, as well as for the aspiration of the resulting emulsion.
- External ‒ it directs radio frequency radiation through the skin and it is a temperature sensor.
The whole operation is performed under careful computer control of the temperature in the intervention zone. As soon as the temperature rises to a critical point, the impulse stops, thus the possibility of a burn is completely excluded.
Radiofrequency body modeling is performed under local anesthesia. Up to 2.5 liters of fat can be extracted during the surgery. The advantages of this type of liposuction are a short recovery period, the minimum number of traces of the exposure, as well as a pronounced lifting effect.
You are sure to be familiar with the method of ultrasonic destruction of gallbladder and kidney stones, so it is quite logical that there is ultrasonic liposuction. This procedure is painless and very effective. A small incision is made in a certain place under local anesthesia. Through it the ultrasonic probe is inserted into the depth of adipose tissue. The ultrasound destroys fat cells forever, which leads to a persistent and long-lasting lipomodeling effect.
By using ultrasound, it is possible to remove a large amount of fat ‒ 6-8 liters. Yet, the operation remains low-impact. Another positive effect of this method of liposuction is an improvement in the skin ‒ it becomes even and smooth.
Water Jet Liposuction
The world pathophysiology has long proved that fat cells are a depot not only of fat, but of many harmful elements (heavy metals, micro-doses of various medical preparations). The destruction of lipocytes during liposuction leads to a massive release of these substances into the human body, which leads to intoxication (poisoning). To avoid this state of things, a new method of body modeling was invented ‒ water jet liposuction.
This method is based on the mechanical separation of fat cells from the connective tissue framework using a jet of water and subsequent aspiration of the resulting fluid. For water jet liposuction a special solution is used, which has the following effects:
- Narrows capillaries.
- Anesthetizes the area where the surgery is performed.
- Separates adipocytes.
To supply this solution under pressure, a special machine is used, on which the number of injections and their strength are set before the operation.
Local anesthesia is used during this procedure. The entire course of the operation is controlled by a plastic surgeon. The advantage of water jet liposuction is that there are no restrictions on the single-stage removal of adipose tissue. Besides, patients do not suffer from edema and pain after the surgery, and the recovery period is limited to 3-4 days.
What should a patient do after the operation?
A patient’s behavior in the postoperative period is the same, irrespective of the method of lipomodeling. Only the period of wearing special underwear and the duration of the restoration of working capacity differ.
In the operating room the patient is dressed in special compression underwear ‒ this is how the sagging of the skin and the formation of hematomas and bruises are prevented. You should wear this clothing for about 2 months without taking it off. Doctors recommend limiting social activity during the first 10 days after liposuction. You also need to reduce salt intake for up to 2 weeks, not to take aspirin and other anticoagulants. When gentle methods of correction are used, recovery from liposuction is faster ‒ in 4-5 days, and sometimes in 3-4 days.
Experts advise to limit the amount of physical activity and insolation during the first 2 months and prohibit the bath and sauna at this time. If a girl wants to get pregnant, she must remember that after liposuction the date of the supposed conception needs to be postponed by 6 months.
Contraindications and Complications after Liposuction
Contraindications for all types of lipomodeling are practically the same:
- Pathology of blood coagulation system.
- Endocrine diseases.
- Obesity associated with genetic pathology.
- Impaired kidney and liver function.
- Gastric ulcer.
- Vascular disease in the area of the operation.
- Heart valvular disease.
- Arterial hypertension.
- Heart pacemakers.
- Presence of oncopathology.
If the operation is performed on a healthy patient, the development of complications is hardly probable, but, unfortunately, it is still possible. The main complications after liposuction are as follows:
- Skin hyperesthesia in the area of the operation.
- The formation of seroma ‒ fluid accumulates in the area of the operation and a kind of cyst is formed.
- Increased skin pigmentation.
- Severe pain.
- Hematomas and bruises.
- Infection of the wound.
- Nausea and dizziness after anesthesia.
- Fat embolism ‒ the possibility of developing this complication increases with an increase in the amount of adipose tissue removed.
Surgical or Apparatus Liposuction
The fear of surgery is a stimulus that drives many people to look for an alternative to classical liposuction. Such a method is apparatus liposuction, for example, ultrasonic lipomodeling by using a cavitation apparatus. The effect of ultrasound on adipocytes is described above, but the essential advantage of this particular method is the absence of even a minimal incision. All manipulations are carried out only through intact skin.
Here is the full list of benefits that non-surgical liposuction gives you:
- Absolute painlessness.
- No need for any type of anesthesia.
- No risk of hematomas and bruises.
- Positive effect on the skin.
- No need to wear compression underwear.
After liposuction, a person should avoid physical exercises and sports for 3-6 weeks. A person should wear compression garments day and night. Showering is allowed 2 days after the operation, and bathing is allowed when scars cure totally.
To improve regeneration of scars after liposuction, a person should use ointments boosting epithelialization and curing. Scars after liposuction should not be exposed to direct sunlight within 6 months. Final result after liposuction will be visible within 3-6 months.
5 Myths about Liposuction
The procedure called “liposuction” has been popular with “thin” people for more than a decade. It would seem that you can eat up cakes and pies, and then pay the money, and the doctor will remove the excess fat. But is it really that simple? Plastic surgeons debunk the five most common misconceptions.
- Liposuction is the only effective method of fast weight loss. Doctors refute this opinion, since this operation is intended only for body contouring plasty, but not for getting rid of excess weight. Both men and women have areas on the body where fat will store, regardless of lifestyle and frequency of exercising. What concerns the beautiful half of humanity, these are the inner side of the knees, abdomen, lower back and chin area. In this case, when exercises are ineffective, you can turn to a doctor.
- During one procedure of liposuction you can pump out a dozen liters of excess fat. But so much fat cannot be removed at a time without provoking abnormalities in the functioning of the body. Even in the most “neglected” cases, doctors usually remove a maximum of 5-6 liters.
- Liposuction spoils the skin. Everything is extremely individual and depends on the age of the patient and his or her skin type. If it is in good tone, the procedure will do no harm. Conversely, liposuction will not give back young skin to aged patients with less elastic skin.
- Long rehabilitation after liposuction. For example, the procedure on the chin implies 4-5 hours for rehabilitation, after which the patient can safely leave the hospital.
- Liposuction is ... liposuction. However, modern plastic medicine offers patients many types of this procedure. For example, removal of excess fat by using ultrasound or laser. The first method is applied to the surface layers of fat, while the second one is relevant for those who have flabby skin with fat.